MEDICARE: AVISTA HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1477409787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVISTA HOME CARE

Provider Business Mailing Address
First Line	:	414 W GRAND BLVD UNIT 372
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92878-7218
Country	:	US
Telephone Number	:	951-577-4360
Fax Number	:

Provider Business Practice Location Address
First Line	:	1453 GOLDENEAGLE DR
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-8891
Country	:	US
Telephone Number	:	951-577-4360
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	GODFREY NWOGENE
Credential	:
Telephone Number	:	951-577-4360

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

Similar Medicare Providers

1295467447 — KEVIN FRYER
Practice Location Address:

341 MAGNOLIA AVE STE 101
CORONA, CA
92879-3331

Practice Phone: 951-735-6060
Practice Fax: 951-735-4510

1407479843 — ANA LAURA PLASCENCIA
Practice Location Address:

109 E 11TH ST
CORONA, CA
92879-2157

Practice Phone: 951-427-3482
Practice Fax:

1932055043 — AVISTA HOME CARE
Practice Location Address:

720 S. RAMONA AVE SUITE 202
CORONA, CA
92879

Practice Phone: 951-577-4360
Practice Fax: 951-356-1782

1619823663 — GUARDIAN CARE TRANSPORT, INC.
Practice Location Address:

101 GRANITE ST STE E
CORONA, CA
92879-1285

Practice Phone: 773-546-8317
Practice Fax:

1477409431 — JEEL BHUVA BPT
Practice Location Address:

2265 LAKESIDE PL APT 206
CORONA, CA
92879-7879

Practice Phone: 951-622-0530
Practice Fax:

1518813518 — KRISTINA BENJAMIN
Practice Location Address:

1295 CORONA POINTE CT STE 102
CORONA, CA
92879-1721

Practice Phone: 855-223-7123
Practice Fax: 619-374-7134

Directions to “AVISTA HOME CARE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.